Emy P, Michenet P, Saint-Marc O
Service d'Endocrinologie, Centre Hospitalier Régional, Hôpital de la Source, Orleans.
Ann Chir. 1998;52(5):461-4.
Microscopic papillary thyroid cancer (< 1 cm in diameter) is reputed to have an excellent prognosis. In 10 to 20% of cases, it presents in the form of lymph ode metastases. Immediately metastatic forms can be associated with unfavourable prognostic factors, such as multifocal tumours, extension to adjacent tissues, capsular effraction and development of distant metastases. We report 4 cases of microscopic papillary thyroid cancer presenting in the form of lymph node metastases. No primary thyroid lesion was palpable in any of these patients, but the subsequent course was complicated by ling metastases in one case. All patients underwent total thyroidectomy with lymph node dissection followed by adjuvant therapy with radioactive iodine and thyroxin inhibitory treatment. Lung metastases were observed in one case. The authors propose a therapeutic approach based on analysis of severity factors, which determine the recurrence rate.
微小乳头状甲状腺癌（直径<1厘米）一般预后良好。在10%至20%的病例中，它以淋巴结转移的形式出现。即刻发生转移的形式可能与不良预后因素相关，如多灶性肿瘤、向邻近组织的浸润、包膜侵犯及远处转移的发生。我们报告4例以淋巴结转移形式出现的微小乳头状甲状腺癌。这些患者均未触及原发性甲状腺病变，但其中1例随后出现肺转移，病情变得复杂。所有患者均接受了甲状腺全切术及淋巴结清扫术，随后进行放射性碘辅助治疗和甲状腺素抑制治疗。1例患者出现了肺转移。作者提出了一种基于严重程度因素分析的治疗方法，这些因素决定复发率。
